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Srpski arhiv za celokupno lekarstvo 2020 Volume 148, Issue 1-2, Pages: 70-75
https://doi.org/10.2298/SARH190108123S
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Corneal collagen cross-linking in pediatric patients with keratoconus

Stanojlović Svetlana ORCID iD icon (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Eye Diseases, Belgrade, Serbia)
Pejin Vedrana (University of Belgrade, Faculty of Medicine, Belgrade, Serbia)
Kalezić Tanja ORCID iD icon (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Eye Diseases, Belgrade, Serbia)
Pantelić Jelica ORCID iD icon (University of Belgrade, Faculty of Medicine, Belgrade, Serbia + Clinical Center of Serbia, Clinic for Eye Diseases, Belgrade, Serbia)
Savić Borivoje ORCID iD icon (Clinical Center of Serbia, Clinic for Eye Diseases, Belgrade, Serbia)

Introduction/Objective. The aim of this study was to report visual, refractive, and tomographic outcomes of corneal collagen cross-linking (CXL) in pediatric keratoconus. Methods. This retrospective study included 17 eyes of 12 patients with progressive keratoconus who underwent epithelium-off CXL at the age ≤ 18 years. Following data were analyzed at baseline and postoperatively at one, three, six, nine, 12 months for all the patients, and annually where available: uncorrected distant visual acuity (UDVA) and best spectacle-corrected distant visual acuity (CDVA), refraction and corneal tomography. Results. Mean UDVA improved significantly from 0.52 ± 0.38 at baseline to 0.24 ± 0.29 logarithm of minimum angle resolution (log MAR) at one year (p = 0.011) and remained stable at two-year follow-up (0.21 ± 0.34 log MAR). Mean CDVA was 0.15 ± 0.21 at baseline and 0.06 ± 0.13 log MAR at one year (p = 0.248). Maximum keratometry showed a significant flattening of 1.30 ± 1.99 D (p = 0.011) after a year and remained stable two years after CXL. Minimum keratometry significantly decreased with a mean change of 1.34 ± 1.37 (p = 0.001). Mean reduction of corneal thickness after CXL was 55.35 ± 64.42 μm (P=0.003). After a year, seven (42%) eyes showed Kmax regression, nine (53%) stabilization, and one (5%) progression. Conclusion. In our study CXL effectively prevented progression of keratoconus in 95% of pediatric patients after a year, while improving UDVA and keratometry values. One patient with eye rubbing behavior showed signs of keratoconus progression after CXL treatment.

Keywords: corneal collagen cross-linking, keratoconus, pediatric patients, CXL